Friday, March 28, 2014

Truth about Attention Deficit Disorders (ADD/ADHD): Reasons and Revelations

Truth about Attention Deficit Disorders (ADD/ADHD): Reasons and Revelations

cchrint.org
There is an epidemic of name-calling by school teachers and psychologists who are freely labeling the children with Attention Deficit Disorders such as ADHD. The epidemic started in the US and other "developed" countries and has now spread to Pakistan thanks to some powerful Hollywood and Bollywood Movies. Clinical Psychology Department of GCU, Lahore, conducted a survey of school teachers which revealed that the teachers consider nearly 60 percent of the children as having ADHD [See References below]. I would be describing the reasons behind this epidemic and five recommendations later in the post, but first consider the following questions:

  1. Do you have difficulty sitting still on a hard chair without cushion for hours? 
  2. Do you have difficulty watching a TV program (that you do not like) attentively till its end? 
  3. Do you have difficulty waiting for your turn in a long queue while there is a more interesting and urgent work beckoning you? 
  4. Do you often move from one channel to another or do channel surfing on cable? 
  5. Do you often find difficult retaining friends as your interests diverge or as you move from one job to another and one locality to another? 
  6. Do your boss complain about your behavior and attitude? 
  7. Do you often find yourself disorganized with too many things that need to be done urgently at the same time? 
  8. Are you often distracted by other thoughts in long boring meetings? 
  9. Do you often find yourself making careless mistakes such as forgetting an important assignment, or a scheduled meeting? 
  10. Do you often blurt out things in the company of your friends and peers that you later on are embarrassed about? 
  11. Do you sometimes forget keys, mobile, charger or your other things?
If your answers to the majority of the above questions is "Yes", then the so called experts and their quizzes would classify you as an ADHD or ADD and they may even recommend to you drugs like Ritalin and treatments like pscyho therapy. Note that the above questions are just a rephrasing of the diagnostic test, which is also given below with my comments.

Isn't this ridiculous!

Yes this is the reality.  Diagnostics like these can result in your child being labeled as ADHD, i.e. diagnosed as having a learning disability and being prescribed medication such as Ritalin that has severe side-effects leading to permanent damage.

Here are the ridiculous questions in the "Quiz: Could Your Child Have ADD/ADHDthat can lead your child to be diagnosed wrongly as an ADHD or ADD. Please note that these questions completely ignore the possible reasons for the observed behaviors, which I think used to be the primary focus of early psychologists.  My comments are in the next column highlighting some plausible reasons that seemed to be ignored by ADHD experts who were developing the questions, and must be ruled out before any drastic labeling or diagnosis:

Sr
ADHD Diagnostic Questions
Ridiculousness of the Question Highlighted when Viewed from Another Perspective
1
Does your child have difficulty sitting still?
Is it the case of sitting in a boring lecture by an unenthusiastic teacher or is it the case of child sitting and playing for hours on a computer/XBox game?
2
Does your child seem to have a short attention span?
Only during a ridiculous senseless, repetitive homework. Not when playing a computer game or a watching a thriller or with a smart phone
3
Does your child have trouble sharing or waiting his turn?
Who would not when there are more interesting things to do and explore than being forced by the teacher to wait in line for a reason that does not make sense to the kid!
4
Does your child frequently and quickly move from one activity to the next?
Which child would not! Just see a child discovering a store like "Toys R Us" where there are so many interesting toys, each one more fascinating than the other, and the child jumping from one to another. A child can discover even in daily objects such excitement and opportunity for exploration. The child will create the space for quenching this curiosity if you don't give it!
5
Does your child have trouble making and keeping friends?
Why is it surprising when the child is imprisoned from a very early age in his home and is not allowed to meet and socialize with extended family (because the mother and father did not have the emotional flexibility to intermingle) and is then imprisoned in a pre-school and then in a school (because both mother and father are busy with house/office work), and is not given any free time to socialize or liberty to explore with his peers new worlds and new civilizations in jungles, parks, junk yards and other exciting places. May be the child does not want to keep the old friends because he has discovered other children with new and more exciting hobbies and gadgets, or may be his interests have changed or the interests of his previous friends have changed. May be it is the alone-together culture that is making us more addicted and connected to gadgets than to our fellow human beings. Should not these reasons  be taken into account?
6
Have your child's teachers complained of behavioral problems?
What do you mean by behavioral problem? Do you equate normal behavior with "sit still and be quiet"? "Behavioral control" is the objective of Pavlov and Skinner who would like to control people with external stimuli and "conditioning". It is but natural for a human being to revolt against this kind unpredictable and senseless controls. Why should a child sit still? This is the time for the child to run around, jump, climb, dive, ride, roll, and slide. Why should the child be quiet? This is the time for the child to learn to talk, interact and develop social skills. Are not we worried about his ability to make friends and keep them? How would he learn this if the only thing he is supposed to do in class is "sit still and be quiet" and is not given opportunity to express and test his socializing skills. Do we want him to sit still and be quiet only because that is how we can imprison the hordes of inquisitive, curious and energetic students in seclusion for hours in what are some times called "Weapons of Mass Instruction"?
7
Does your child frequently seem distracted and disorganized?
Who does not! A child has to do so many things, learn so many new things, learn new skills, explore new toys, explore new environments. Isn't it unnatural for the kid to be holed up in a room with senseless insipid instructions being given by teachers who often have no passion or interest or hobby
8
Does your child often make careless mistakes at home or at school?
We all make careless mistakes like forgetting important appointments, birthdays, tasks. Don't you think child has many important things to do?
9
Does your child frequently act impulsively and without thinking?
Isn't this the childhood innocence that we all cherish and have nostalgia about? Why do we forget that we often lose our handle, especially when we are angry. Over the years, we have learned to be "diplomatic" i.e. suppress the truth and even lie with straight face. In the beginning a child never lies. We teach him to lie. A child is initially impulsively straightforward and logically correct. We destroy his impulsively logical correctness by teaching him to hide information, and hide truth by classifying such behaviors as "disorders".
10
Does your child often lose and forget items?
Who does not. I often forget my keys, papers, mobile, charger, and other things. I had gone through training programs on self-organization and time management and have gone through Stephen Covey and what not, but am not yet able to manage and organize and track every thing the way it needs to be done. Yet we want the child to be doing it without such extensive trainings!

The Parents magazine article, Attention for ADHD (May 2012), lists nine key facts about ADHD. One can easily see the emptiness of these so called "facts".

Sr
9 Key Facts about ADHD
Emptiness of these “Facts”
1
The brains of kids with ADHD are different.
Is not the grey matter different in every brain?
2
No one knows the exact causes of ADHD.
No one even knows the exact process of how we think and act
3
ADHD often looks different in girls.
There are so many things that look different in girls!
4
ADHD can make learning difficult.
Senseless learning is always difficult. See Langer's Mindful Learning
5
ADHD is tricky to diagnose.
Wouldn't it be, if the there are questions about ADHD being a problem in the first place!
6
There is no cure for ADHD, but there is effective treatment.
If something is not a disease then why should there be a cure. Of course the child can always grow out of it with the right environment.
7
Kids can be taught to cope with ADHD.
Man can be taught to cope with much worse situations, even imprisonment, impoverishment, and abuse and what not
8
Parents can also be taught to cope with ADHD.
No wonder this is fast becoming the Huxley's Brave New World
9
Kids with ADHD also have it as adults.
Look closely and you will find all of us to some extent ADHDs. See questions at the start of this post.
I now come to the ridiculous "Symptoms of ADHD" from www.parents.com.  But before you read the symptoms bulleted below, consider this:

A normal child typically requires at least 4-6 hours of physical exercise every day. Given this requirement, if a child is imprisoned in schools and with homework, then his normality would force him to exhibit the worrying behavior. I should be surprised and worried if a normal child who is imprisoned does not appear "Hyperactive and impulsive". ADHD experts probably forgot to observe mothers of small kids. A mother instinctively gets worried if for some period of time, she does not hear some cracking, pushing, noise, screech, and squeak coming from where the child is. Absence of noise is her measure of abnormality, not presence of noise and dint. Now consider the "Hyperactive and Impulsive" symptoms of ADHD:

Sr
Symptoms of ADHD
More Understandable Reasons
1
He fidgets and squirms a lot
May be he feels imprisoned in his chair.
2
He often gets up out of his seat.
Wouldn't he if needs to go out and play and get some physical exercise.
3
He run or climbs excessively
He needs to do more of this. Take him to some park or jungle.
4
He has trouble playing quietly
Then you worry about him not having friends. Of course he wants to be with his friends and play with them outside
5
He always seems to be on the go or driven by a motor
Good. Get Life! We should all have a go in us.
6
He talks excessively
Of course. Give him a mike. A recording machine. Provide him with a stage, get him into some drama club, or teach him stand up comedy.
7
He blurts out answers
We would be also worried if he does otherwise.
8
He has trouble waiting for his turn
I would be too if I am so much excited. Let him grow up, he will be OK.
9
He interrupts or intrudes often
Why are you serious? He is just a kid!

Consider the following symptoms of ADHD representing the third set of behaviors -- inattention. Note that these symptoms could only have been made by a person who has not had extensive exposure to several small children growing up. By now you have gotten the drift of what I am saying. Need I give comments to the following?
  • He makes careless mistakes 
  • He has trouble paying attention to a task 
  • He doesn't seem to be listening when spoken to directly 
  • He doesn't follow instructions 
  • He has trouble organizing 
  • He avoids or dislikes sustained effort 
  • He is always losing things 
  • He is easily distracted 
  • He is forgetful 
My God! Give him some space. Don't blurt out things without thinking. He is just a kid!!

Five Recommendations:

  1. Treat the kid as you want him to be, not as he is. If you treat him as if he is disorderly, he would continue to act in a disorderly fashion. If you treat him as a responsible person, he would act responsibly. Please note a child can see through your words and knows when you are sincerely saying something, and when you are hypocritically saying some thing. Have trust in the kid and his abilities. Don't suspect him or his abilities. He knows what you are thinking, and his behavior becomes a reflection of your expectations. 
  2. Change your lifestyle. Go often to parks, go for tracking, hiking, climbing, swimming, exploring, fishing, surfing, ... Go for long excursion trips to the mountains. If you think you are already doing this, then you are not doing enough. You need to substantially increase the frequency. Engage some help for such outings, if you are too busy. Although, the child needs you more than the hired help. His behavior may actually be a protest against too little time that you are giving to him. After all, he is your child and you are so much concerned about his health!
  3. Take him to a true educationist who deals with healthy kids and who is into modern research on education. Do not take him to a career school administrator who is not up to date with current books and current research, and definitely not to some psychologist/psychiatrist who deals with diseased minds. Go through this checklist, first, if you are really very worried you must take him to some expert.
  4. If the school is reporting this, then change the school. School administrators are often not qualified to be educationists, they have not read the research and modern approaches to education. Their knowledge is restricted to on-job training at particular types of schools.
  5. Believe in your child and his abilities. See Education as Tazkia

What are Origins/Reasons of this Epidemic of ADD/ADHD?

See Also: 

References:


7 comments:

  1. Doctor Sahib the symptoms seem to have been written by a very amateur and immature psychologist or group of psychologists with no fear of God. just imagine the vast devastation this is going to cause to so many children in Pakistan. I was told of a case where a normal 6 yr student was referred to a psychologist with ADHD prescription and was overdosed with Ritalin and as a result is bedridden at 19 yrs of age with the brain function of a 3 yrs old.
    Let us take common stand against this horrendous crime against humanity.

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  2. I would like others who are reading this post and who would like to engage in this debate against the use of pseudo-psychological-science for labeling children and boxing them in a corner to join and remove such misconceptions. Much of the research being done today is rubbish, devoid of content and consisting of mindless application of survey tools providing no new insight and actually misguiding people.

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    1. Sir, I completely agree with the labeling part. Same is the case with eating disorders. I have seen people targeting/labeling individuals as eating disordered patient just because they eat healthy. What's more, there is no Pakistan specific tools/questionnaires present to measure these symptoms. If you like, you can read this research paper I wrote.
      http://www.academia.edu/19560720/Trends_of_Eating_Disorder_a_survey_among_young_women_in_Karachi

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  3. The first time I heard of ADHD was in my third year of Medicine, mentioned in a Pharmacology book as one of the indication of a classification of drugs - Methylphenidate and Amphetamines which increase neurotransmitter functions of the brain, thus increasing attention span. It is strange how the concept of ADHD has recently risen in Pakistan causing great concern for parents to stereotype their children and separating them from the norm.
    I know of a local NGO running in Karachi, dedicated for creating awareness of ADHD. They have designed and conduct special training programs by a group of psychologists for teachers, parents and relevant stakeholders. Renowned psychiatrists are come as guest speakers as well. This is a questionable 'service' to humanity and Sir, after reading your blog, I strongly believe that we need to generate more voice to stop isolating a child from a healthy environment which can deeply limit his/her personal development and so of the parents as well.

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    1. You are dot on target. We need to do something about this epidemic of mis-diagnosing a behavior that is NOT a medical condition, but is being classified as such requiring expensive therapy sessions, tests, medications. A condition that does not require any specialized treatment beyond changing our lifestyle to accomodate the needs of a child. There needs to be some kind of campaign against such "pseudo-science" practitioners.

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  4. AoA, I want to share my experience of dealing with an ADHD child who was considered as ADHD by his parents also, on confirmation by a Psychologist. The teachers'left him unattended by saying, that "he doesn't sit in the class and we have no time to give individual attention to him." I personally interacted with him, gave him hardly 15-20 minutes daily. He started sitting with me. We read books together, then I talked to his parents and scheduled his syllabus in small chunks, designed special worksheets for him. I catered to him individually and he picked up so fast. His attention span increased and he started loving his studies while working with me.
    The Problem with our people is that they take up these so called Learning Disabilities labeled' Diseases' as new gadgets of Modern Technology wholeheartedly and believe that 'IF' they won't adopt them then they would be called backwards or conservatives in the modern world so they take pride in having a 'Dyslexic' or 'ADHD' or 'Autistic' child in their family.
    We need to create an awareness about these fake concepts through an Awareness Workshops. I'm with you Dr Irfan. You can letme me when can we deliver it.

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    Replies
    1. I think preparing a workshop on this subject is a wonderful idea. Let's meet n discuss

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